Publications by authors named "Irshad H"

Public and private medical institutes must adhere to the same standards of quality set by the Pakistan Medical & Dental Council (PMDC). However, studies have noted varied learning environments. The current study aims to assess opportunities and compare the differences in perceptions between the two sectors.

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  • Excessive fluoride use and chloroform exposure pose health risks, prompting the need for effective sensors to monitor these substances.
  • Researchers investigated etoricoxib (ECX) as a safe and available sensor, revealing its strong fluorescence response for detecting fluoride and chloroform at very low levels.
  • Advanced analyses, including UV-Vis and DFT studies, confirmed that ECX operates through non-covalent interactions, making it a promising tool for real-time detection of fluoride and moisture in various samples.
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 Neurosurgery receives several applicants every year, but the decreasing size of the neurosurgery workforce in Pakistan despite evidence of initial student interest is perplexing. Therefore, it is vital to evaluate the perspective of medical students and recent graduates to get a holistic view of perceptions toward neurosurgery.  A nationwide cross-sectional study was conducted on a sample of medical students and recent graduates from different medical colleges.

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Purpose: The incidence and outcomes of glioblastoma (GBM) patients in Pakistan remain unassessed owing to a lack of cancer registries and the absence of population-based studies. For any specific population-based oncological intervention, epidemiology must be studied. Therefore, this study aims to examine the epidemiological characteristics of glioblastoma patients in Pakistan, as part of a secondary analysis of a nationwide epidemiological study.

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Background: Appropriate surgical infrastructure is important for improving patient outcomes. However, low- and middle-income countries (LMICs) often struggle to provide adequate brain tumor surgery due to fractured infrastructure. This study aims to identify and evaluate barriers to surgical care infrastructure for brain tumors in LMICs.

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Objective: To evaluate the role of endovascular thrombectomy (EVT) in patients presenting with acute ischemic stroke (AIS) due to large vessel occlusion in the very late window (>24 hours).

Methods: A systematic review was conducted according to PRISMA guidelines using PubMed, CINAHL, Scopus, and Google Scholar databases till 2024. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS).

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  • Cannabidiol (CBD), a compound gaining popularity for its potential health benefits, is usually consumed through ingestion and inhalation, but the effects of inhaling CBD are less understood compared to oral consumption.
  • In a study involving Sprague Dawley rats, researchers evaluated the effects of CBD inhalation at significantly higher doses than typically consumed by humans, finding that high doses led to inflammation and necrosis in the nasal area, while lower doses showed no adverse effects in other organs.
  • The study suggests that when using over-the-counter vape products (which contain much lower doses of CBD), there is a substantial safety margin, indicating that typical use is much safer than the higher doses tested.
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Objective: To compare outcomes of middle meningeal artery embolization (MMAE) alone versus combined with conventional surgery in the management of chronic subdural hematoma (cSDH).

Methods: A systematic literature search was performed on PubMed, Google Scholar, Scopus, and CINAHL, followed by a meta-analysis comparing recurrence rates, surgical rescue, mortality, in-hospital complications, and length of hospital stay was conducted. Mean differences and risk ratios were pooled using a random effects model, with subgroup analysis performed using Cochrane RevMan 5.

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  • The study focused on renal tumors with inferior vena cava (IVC) and intracardiac (IC) extension in pediatric patients treated at Aga Khan University Hospital in Karachi, Pakistan, over an 18-year period.
  • A total of 18 out of 61 patients presented with IVC/IC extension, predominantly involving Wilms tumor, with most surgeries resulting in tumor regression and a low mortality rate.
  • The study found a higher incidence of tumor extension compared to previous literature, highlighting the need for multi-center research to improve surgical management and patient outcomes in similar settings.
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Background: Adjuvant therapy is an important tool in the arsenal of brain tumor management and can improve patients' outcomes significantly but low- and middle-income countries (LMICs) often face challenges in provision. Therefore, our study aims to highlight barriers and strategies to adjuvant therapy of brain tumors in low-resource settings.

Method: A comprehensive search of literature was conducted using PubMed, CINAHL, Google Scholar, and Scopus, from inception to October 20, 2022.

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Objective: While early diagnosis of brain tumors is essential for improving prognoses, several challenges prevent early diagnosis of these illnesses in low- and middle-income countries (LMICs). The objective of this systematic review is to identify and evaluate the barriers and challenges to early detection of brain tumors in LMICs, as well as to propose potential solutions.

Methods: A thorough search of the literature was carried out with the aid of multiple databases, including Google Scholar, CINAHL, PubMed, and Scopus.

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Background: Low- and middle-income countries (LMICs) often struggle to provide adequate neurosurgical care due to poor governance and institutional efforts, making access to care difficult. Therefore, our review of literature aims to identify gaps in government, national, and institutional efforts to combat barriers to neurosurgical care of brain tumors in LMICs, to inform future policy and action planning.

Methods: A comprehensive literature search was conducted using PubMed, Scopus, Google Scholar, and CINAHL without language restrictions from inception to October 20, 2022.

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  • Health care in low- and middle-income countries (LMICs) struggles with inadequate data management and national cancer registries, hindering the understanding and treatment of brain tumors.
  • A literature review identified 23 studies revealing significant challenges such as poor hospital records (43%), absence of a national brain tumor registry (67%), and low research output (33%).
  • Strategies to improve data management include enhancing recording systems (45%), establishing a population-based brain tumor registry (64%), and creating local treatment guidelines (9%), requiring government and public health support for effective implementation.
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Acute respiratory viral infections, such as pneumovirus and respiratory picornavirus infections, exacerbate disease in COPD and asthma patients. A research program targeting respiratory syncytial virus (RSV) led to the discovery of GS-7682 (), a novel phosphoramidate prodrug of a 4'-CN-4-aza-7,9-dideazaadenosine -nucleoside GS-646089 () with broad antiviral activity against RSV (EC = 3-46 nM), human metapneumovirus (EC = 210 nM), human rhinovirus (EC = 54-61 nM), and enterovirus (EC = 83-90 nM). Prodrug optimization for cellular potency and lung cell metabolism identified 5'-methyl [()-hydroxy(phenoxy)phosphoryl]-l-alaninate in combination with 2',3'-diisobutyrate promoieties as being optimal for high levels of intracellular triphosphate formation and .

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  • Pediatric brain tumors (PBTs) face delayed diagnoses in low- and middle-income countries (LMICs) due to vague symptoms and socioeconomic factors, impacting survival rates.
  • A systematic review revealed that nonspecific symptoms and family financial issues are primary contributors to diagnostic delays, with patients experiencing an average prediagnostic interval of about 230 days.
  • The findings highlight the urgent need for targeted policies to improve awareness and healthcare access in LMICs, addressing multifaceted barriers to timely diagnosis.
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  • High concentrations of deferasirox (DFX) can lead to serious health issues in the liver, stomach, and kidneys, making it crucial to develop an effective detection method to safeguard public health.
  • Researchers created a thiourea-based probe called MPT that detects DFX by utilizing fluorescence quenching, a process where light emission decreases due to interaction with DFX.
  • Various analytical techniques, including H-NMR titration, dynamic light scattering, and electron microscopy, were used to confirm the interaction between MPT and DFX, demonstrating its ability to detect DFX in real samples like human plasma and artificial urine.
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Background: Ultra-low-field magnetic resonance imaging (ULF-MRI) has emerged as an alternative with several portable clinical applications. This review aims to comprehensively explore its applications, potential limitations, technological advancements, and expert recommendations.

Methods: A review of the literature was conducted across medical databases to identify relevant studies.

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 Pakistan has a significant proportion of medical graduates who intend to leave the country for better opportunities abroad, leading to a brain drain. However, the push and pull factors within neurosurgery remain unexplored, emphasizing the need for evaluation to enact policy changes.  We conducted a nationwide survey across 22 College of Physicians and Surgeons of Pakistan accredited neurosurgery training centers in all provinces of Pakistan.

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Background And Objectives: Brain tumors have a poor prognosis and a high death rate. Sufficient aftercare is necessary to enhance patient results. But follow-up care provision is fraught with difficulties in low- and middle-income countries (LMICs), where a variety of variables can impede access to care.

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Limited neurosurgical workforces remain one of the critical problems experienced in low resource settings. Therefore, our study aims to explore and summarize the key challenges to neurosurgical care of brain tumors in terms of workforce in LMICs. A comprehensive literature search was conducted using Scopus, PubMed, CINAHL, and Google Scholar from inception to October 20, 2022.

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Mastitis is considered one of the most widespread infectious disease of cattle and buffaloes, affecting dairy herds. The current study aimed to characterize the Staphylococcus aureus isolates recovered from subclinical mastitis animals in Pothohar region of the country. A total of 278 milk samples from 17 different dairy farms around two districts of the Pothohar region, Islamabad and Rawalpindi, were collected and screened for sub clinical mastitis using California Mastitis Test.

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Background: Making neurosurgical care accessible to a larger portion of the population in low- and middle-income countries (LMICs) is integral due to the high mortality and morbidity associated with brain tumors. However, the high cost of care often makes it financially out of reach for many individuals. Therefore, this review aims to identify barriers to neurosurgical care of brain tumors in terms of financing in LMICs.

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Objective: A meta-analysis was conducted to compare: 1) time from traumatic brain injury (TBI) to the hospital, and 2) time within the hospital to intervention or surgery, by country-level income, World Health Organization region, and healthcare payment system.

Methods: A comprehensive literature search was conducted and followed by a meta-analysis comparing duration of delays (prehospital and intrahospital) in TBI management. Means and standard deviations were pooled using a random effects model and subgroup analysis was performed using R software.

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